Objective To investigate the distribution of five indicators of hepatitis B(HBV-M)and its relationship with liver function parameters and HBV-DNA load in patients with chronic HBV infection in different stages.Methods The serum samples were collected from 456 patients infected with HBV.The HBV-M,liver functional parameters and HBV-DNA level were quantita-tively detected.According to the stages of disease,the patients were divided into 3 groups including chronic hepatitis B group(inclu-ding mild subgroup,moderate subgroup and severe subgroup),liver cirrhosis group(including compensatory subgroup,decompen-sated subgroup)and hepatocellular carcinoma goup.Results The ratio of HBsAg,HBeAg,HBcAb positive pattern(135 pattern) and HBsAg,HBeAb,HBcAb positive pattern(145 pattern)in the three groups were statistically different(P <0.05).In each chron-ic hepatitis B subgroup,both ALT and AST levels of 135 pattern were significantly higher than the other two patterns(P <0.05). In each liver cirrhosis subgroup and hepatocellular carcinoma group,there were statistically significant differences in ALB and TBIL levels between the three patterns(P <0.05 ).In each group,the HBV-DNA level of 135 positive pattern were significantly higher than the other two patterns(P <0.05).Conclusion With the advancement of chronic hepatitis B,there is a downtrend in the ratio of 135 pattern and increasing trend in the ratio of 145 pattern.If the stage of hepatitis B is discriminated,ALT,AST,ALB TBIL and HBV-DNA level were closely related to HBV-M pattern.

ObjectiveTo investigate the expression of Twist protein in adenocarcinoma of prostate and clinicopathological features and explore its roles in the carcinogenesis and progression of adenocarcinoma of prostate and its relationship with prognosis.MethodsThe expression of Twist was detected in 70 cases with adenocarcinoma of prostate and 30 cases with side cancer tissue by immunohistochemistry (EnlivionTM).ResultsThe expression of Twist protein in adenocarcinoma of prostate was higher than side cancer tissue.The expression of twist was related to Gleason grade,clinical stage and bony metastasis (P＜0.05),but it was not related to the age (P＞0.05).The survival rate of Twist protein positive patients was significant lower than negative patients(x2=9.52,P＜0.01).ConclusionsTwist might be an important biological marker for malignant transformation and invasion and metastasis adenocarcinoma of prostate,and the up-regulation of the expression of Twist reflects more invasion and poor prognosis.

Objective To evaluate CTA characteristics of anomalous origin of coronary artery from the pulmonary artery (ACAPA).Methods The clinical data of 24 patients with ACAPA were retrospectively analyzed,and the results of CTA were compared with operation.Results In 24 ACAPA cases,20 cases (20/24,83.33％) occurred in the left coronary artery (LCA),1 case (1/24,4.17％) was in the right coronary artery (RCA),1 case (1/24,4.17％) was in the anterior descending artery (LAD) and 2 cases (2/24,8.33 ％) were in the circumflex artery (LCX).The origins of coronary anomalies originated from the posterior wall of the pulmonary sinus or pulmonary trunk in 11 cases (11/24,45.83 ％),left wall in 7 cases (7/24,29.17％),right wall in 4 cases (4/24,16.67％),originated in the left pulmonary artery in 2 cases (2/24,8.33％).Collateral circulation:Infant type was in 5 cases,no collateral vessels between the coronary artery was observed;adult type was in 19 cases,of which 16 cases were of abnormal origin of the LCA and RCA,1 case was of LAD,2 cases were of LCX.The double LAD and coronary arteries with an intramural segment were found in 1 case respectively.Surgery were performed in 19 cases.Five cases were reviewed by CTA,1 case with anastomotic stenosis of LCX,1 case with restenosis of right ventricular outflow tract and 1 case with coronary pseudoaneurysm.Conclusion CTA can clearly show the origin of abnormal coronary artery,the distance from the ascending aorta,collateral vessels,combined with other coronary artery malformations,which can help surgical preparation of preoperative surgical approach,and postoperative follow-up.

Objectives: To observe the drug seeking behavior in chronically morphine pretreated, abstinent rats and determine brain regions involved in this behavior. Methods: Preferences for morphine associated environments and Fos expression in some brain regions were measured 35 days after withdrawal of chronic morphine treatment. Results: The preference for the morphine environment was greatly increased by morphine pretreatment. The conditioned morphine pretreated group showed significantly higher Fos levels than either the conditioned or non conditioned control groups in the Cg, Ac C, BNST VL, ACE and ABL. Conclusions: A relationship between place preference behavior and neural indices of activation exist in the forebrain in response to morphine conditioned cues, which may be chronically modulated by prior morphine exposure.

The transcription activity of ectogenic human carcinoembryonic antigen (CEA) promoter in lung adenocarcinoma cells A549 was investigated for the further gene-targeting therapy. The reporter gene green fluorescent protein (GFP) driven by CEA promoter and human cytomegalovirus (CMV) promoter were relatively constructed and named plasmid pCEA-EGFP and pCMV-GFP respectively. The intensity of fluorescence was detected by fluorescence microscope and flow cytometry analysis after the pCEA-GFP and pSNAV-GFP plasmids were transfected into A549 cells through liposome respectively. The results showed (4.08+/-0.63) % of the A549 cells transfected with pCEA-AFP plasmid expressed, significantly lower than that of the A549 cells transfected with pCMV-GFP [(43.27+/-3.54) %]. It was suggested that ectogenic human CEA promoter in lung adenocarcinoma cells A549 was weakly expressed. The distinct specificity of CEA promoter in CEA high expression cells was regarded as a tool in selective gene therapy, but the transcription activity of ectogenic human CEA promoter was needed to increase in the future.

Objective To explore the surgical intervention outcomes of necrotizing enterocolitis (NEC)pa-tients with different extent of the disease.Methods The data of 25 pediatric patients with NEC who were treated with surgical intervention in Shanghai Children′s Hospital from December 201 1 to December 201 5 were retrospectively ana-lyzed.According to the extent of the disease,the patients were divided into 3 groups:focal disease(F),multisegmental disease(M),and pan -involvement(P).The information including operation style,survival rate and time for close osto-my was analyzed.Results There were 1 1 cases with F,8 cases with M,and 6 cases with P.All patients received lapa-rotomy surgery,colostomy,or peritoneal drainage.There were 1 2 patients with very low birth weight,7 patients with low birth weight,6 patients with normal birth weight in this study.There were 1 7 cases with gastrointestinal perforation (9 cases with pneumoperitoneum,8 cases without pneumoperitoneum),8 cases without digestive tract perforation (4 cases without pneumoperitoneum,4 cases with enterostenosis after conservative treatment).In this study,close ostomy was commonly conducted 3 -6 months after the operation,except for 3 cases who received 2 or more times of operation.The survival rate in F group was 1 00.0%(1 1 /1 1 cases),higher than those in the Mgroup with 62.5%(5 /8 cases)and P group with 1 6.7%(1 /6 cases)(χ2 =4.898,1 0.31 2,all P <0.05).However,there was no difference between Mgroup and P group (χ2 =1 .367,P >0.05).Conclusions The extent of disease is correlated to the outcomes of surgical in-tervention,as F had a better outcome than Mand P.Low birth weight is a risk factor for NEC.Protecting the edge of the bowel is a key factor to ensure the survival and improve the quality of life of NEC patients.Close ostomy should be con-sidered when the patients are in a stable condition (liver function and intestinal function recovery,good nutrition condi-tion,etc),and under special circumstances to conduct early or delayed closure of fistula.

Objective To enhance awareness of the dangerous of multiple magnets ingestion in children and to explore the optimal treatment of it.Methods The clinical data of 3 cases with multiple magnet ingestion were retrospectively studied based on literature review.Results Ingestion of multiple magnets (range:2-5 magnets) magnets occurred in 3 cases.Age ranged from 1 to 8 years old.Magnet sources included:2 from children's family,1 from their kindergarten.All patients had several bowel perforations(range:2-4).One case was completed by laparoscopic,1 case was converted to open suegery after laparoscopy,1 case was done by open surgery.All cases got complete recovery after surgical treatment,and no complications occurred by follow-up.Conclusions Ingestion of multiple magnets may show minimal initial physical manifestations at beginning but may result in significant complications later.Two or more magnets separated from each other along the gastrointestinal tract can attract each other across bowel walls,with may result in pressure necrosis,bowel perforation,and fistulas formation and even death.Early surgical consultation with an aggressive surgical approach is recommended.Family and society should be aware of the dangers of magnet ingestion.

Objective Evaluating the imaging value of dual source computer tomography angiography (DSCTA) in diagnosis of anomalous origin of one pulmonary artery.Methods Clinical data of 13 patients with anomalous pulmonary artery diagnosed with DSCTA were retrospectively analyzed,and compared with data of echocardiography examination.Results The anomalous pulmonary was clearly diagnosed with DSCTA,which all originated from ascending aorta (AAO).Thirteen cases presented with anomalous right pulmonary artery.Of the total,11 cases originated from the proximal AAO,and 2 cases originated from the distal AAO.One patient was only with anomalous origin of right pulmonary.11 were complicated with PDA,7 were complicated with aortopulmonary septal defect and interruption of aortic arch(A type),1 case was complicated with dysplasia of aortic arch,1 case was complicated with aberrant right subclavian arteries,1 case was complicated with tetralogy of fallot(TOF),and 5 were complicated with right-sided aortic arch and right-sided descending aorta.Eight cases with anomalous pulmonary were diagnosed with echocardiography,3 cases were suspected,and 2 cases were missed.One case was complicated with TOF,5 cases were complicated with aortopulmonary septal defect,interruption of aortic arch (A type) and patent ductus artery (PDA),and 10 cases were complicated with moderate-severe regurgitation of tricuspid.In the 7 operative patients,there were consistent with DSCTA,the anomalous pulmonary and the complicated deformities were rectified.Conclusion DSCTA owns a high value in diagnosis of anomalous origin of pulmonary artery and complicated abnormities by clearly developing the pathologic anatomic features and cardiovascular malformations.

Objective: To investigate the multi-imaging diagnostic values, especially MSCT technology in patients with congenital aortic diverticulum with its clinical application. Methods: The MSCT ifndings in 12 patients with congenital aortic diverticulum were retrospectively analyzed. Results: There were 9 patients with right aortic arch and 1 with left aortic arch, all of them having coexisted aberrant subclavian artery which initially dilated like aneurysm by diverticulum changing (Kommerell diverticulum), and there was 1 patient with incomplete double aortic arch with atresia of left arch combining retro-esophageal aortic diverticulum (RAD) and 1 patient with ducts diverticulum. Echocardiogram only made the suggestive diagnosis of speeding up blood lfow or right aortic arch in 4 patients. While MSCT accurately displayed the diverticulum for the location, morphology and with or without other complications. The post-eroanterior chest radiograph indicated “double aortic node” as the special sign in 8 patients. The echocardiogram, X-ray and MSCT for correctly diagnosing the aortic diverticulum were as 0, 72.7% and 100% respectively. Conclusion: MSCT is a rather ideal non-invasive diagnosing method for aortic diverticulum, meanwhile X-ray could also make suggestive diagnosis; if MSCT and X-ray joint with echocardiogram examination may provide the effective supplement for valve structure and hemodynamics condition in relevant patients.

Objective To analyze the reason of hemoptysis after the bidirectional Glenn shunt procedure on complex congenital heart disease.Methods The feature of imaging data of 24 patients (1 6 males,8 females;age ranges:3-27 years;14 cases of single ventricle,3 cases of tricuspid Atresia,4 cases of pulmonary Atresia,3 cases of double Outlet Right Ventricle)after the bi-directional Glenn shunt procedure were retrospectively studied.Results Six patients had various degrees of hemoptysis (50 - 300 mL)after surgery,except for one case which has bronchiectasis on the left inferior lobe.The common feature of the other 5 cases present as plaque ground glass opacity and pulmonary arteriovenous fistula located at the corresponding subpleural field.After different therapy (three cases were performed endovascular management,2 cases were under expectant treatment),the lesion disappeared or obviously smaller which was clear evidence for the existence and bleeding of fistula.The occurrence of this disease in the present study was nearly 20.8%,which were accord with references.Conclusion Pulmonary arteriovenous fistula should be considered when crypto-genic hemoptysis happened after bi-directional Glenn shunt with complex congenital heart disease which exclude tuberculosis,bron-chiectasis or rupture and bleeding of MAPCAs.Multiple sliced CT angiography can be used to as the first line examination and sup-ply acute evidence for clinic therapy in time.